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At least 127 records · Page 7Linked to original sources
PubMed1981

[Determination of gallstone ileus using emergency gastroscopy].

It is reported on the diagnosis of a gallstone ileus in a 73-year-old female patient. In an otherwise quiescent anamnesis an increasing vomiting has been since 10 days. The X-ray examination of the stomach with visotrast 370 resulted in the suspicion of a pyloric stenosis. By means of emergency gastroscopy an independent disease of stomach and duodenum was excluded, but in the duodenal bulb 2 gallstones of the size of a hazel-nut and a kernel of the hazel-nut with references to a cholecystoduodenal fistula were established. In this case the emergency gastroscopy resulted in the indication to the immediate operation on account of gallstone ileus with previously unclear symptomatology of an ileus. Additionally a nearly hen's egg-sized stone was removed aborally 30 cm from Treitz's fascicle.

Aged↗
PubMed1997

Open access gastroscopy findings are unrelated to the use of aspirin and non-steroidal anti-inflammatory drugs.

This study aims to determine whether priority should be given to patients taking non-steroidal anti-inflammatory drugs (NSAIDs) or aspirin when selecting which dyspeptic patients to refer for open access gastroscopy. A total of 8156 patients underwent gastroscopy, all of whom had upper gastrointestinal symptoms. Patients taking NSAIDs or aspirin showed no significant differences in the frequency of ulcer disease when age-matched groups were compared. Although NSAIDs and aspirin are frequently implicated in gastrointestinal bleeding in the elderly, patients referred for investigation of dyspepsia show no increase in major endoscopic pathology.

Adult↗
PubMedDate not supplied

Oxygenating mouthguard alleviates hypoxia during gastroscopy.

A randomized study was carried out to determine the effect of oxygen (3 liters/min) via a novel oxygenating mouthguard (Oxyguard) on arterial oxygenation in 242 intravenously sedated patients undergoing gastroscopy. In another group of 21 patients, a randomized crossover study of arterial oxygen saturation using either the standard mouthguard or the oxygenating mouthguard (3 liters/min) was conducted. Significant O2 desaturation (pulse oximeter reading less than 90%) occurred in 25% of patients on room air but only 3% of those on oxygen (p less than 0.001). Severe desaturation (reading less than 85%) occurred in 5% of patients on room air but was prevented by the oxygenating mouthguard. Minimum oxygen saturation levels were significantly higher in patients on oxygen (90.5 +/- 0.3%) than on air (86.5 +/- 0.5%; p less than 0.001). In the crossover group, O2 saturation was uniformly higher in the recordings of all patients using the oxygenating mouthguard. In conclusion, administration of oxygen via the oxygenating mouthguard alleviates hypoxemia during gastroscopy and prevents severe oxygen desaturation. However, hypoxemia may occur even during use of supplemental oxygen. Hence, monitoring of arterial oxygenation is recommended.

Equipment Design↗
PubMed1977

Comparative effects of tolfenamic acid and acetylsalicylic acid on human gastric mucosa. A double-blind crossover trial employing gastroscopy, extern gastrocamera and multiple biopsies.

A comparative study has been made of the effects of tolfenamic acid (Clotam) and acetylsalicyclic acid on the gastric mucosa in 10 healthy volunteers. The effects were evaluated by means of gastroscopy, photography of the gastric mucosa, and multiple biopsies. The schedule was for a randomized, double-blind crossover trial involving two drug-administered periods of one week's duration separated by an interval of at least 3 weeks. On each day of the drug-administration weeks either tolfenamic acid 600 mg or acetylsalicyclic acid 3 g was administered as three divided doses, taken with meals. Gastroscopy was performed prior to and after each week of drug administration. Subjective side effects were recorded during the therapy periods; haematemesis occurred in 2 volunteers taking acetylsalicyclic acid. The absence of gastritis in each subject during treatment with tolfenamic acid was confirmed both gastroscopically and histologically. In contrast, 6 out of 10 volunteers developed mild superficial acute gastritis after ingestion of acetylsalicyclic acid. The difference in effect between the two treatments on the gastric mucosa was statistically significant(p less than 0.05). The findings of this study are comparable to those of other studies and it is concluded that tolfenamic acid, in the relatively high dosage employed in this trial, is free from any irritant effect on the gastric mucosa.

Adult↗
PubMed1981

[First-line exploration: fiberoptic gastroscopy or barium meal? A pragmatic evaluation (author's transl)].

The influence of the initial upper GI tract exploration upon the accuracy and cost of diagnosis was evaluated in 103 in- and out-patients of a hepato-gastroenterology unit. The patients were divided at random into two groups of comparable number, age, sex and clinical findings. One group was first examined by fiberoptic gastroscopy and the other by barium meal. In patients whose first examination was by endoscopy a second examination was less frequently needed (3/53 versus 14/50; p less than 0.01), significant lesions (e.g. oesophagitis, oesophageal varices, gastroduodenal losses of substance or tumours) were more often diagnosed (22/53 versus 11/50; p less than 0.05) and the time required for a diagnosis to be made was shorter (mean 7 +/- 6 days versus 14 +/- 16 days; p less than 0.01), even when only one examination was performed (7 +/- 6 days versus 12 +/- 15 days; p less than 0.05), than in patients first examined by barium meal. It is concluded that fiberoptic gastroscopy should be the initial method of exploration of the upper GI tract.

Adult↗
PubMedDate not supplied

Open access gastroscopy--3 year experience of a new service.

We have audited the first 3 yr of a new open access gastroscopy service in the Royal Victoria Hospital, Belfast to assess service demands, patient demography and diagnostic trends. Over 3 yr there were 1872 referrals (800 from fundholding general practitioners), 8.8 per cent were non attenders and 5.4 per cent cancelled appointments. Endoscopic diagnostic categories showed no significant change over the 3 yr, 39 per cent non ulcer dyspepsia, 35 per cent gastro-oesophageal reflux disease (GORD), 17 per cent peptic ulcer disease (PUD), 6 per cent GORD and PUD, 1 per cent gastric erosions and 0.8 per cent carcinoma.

Adolescent↗
PubMedDate not supplied

Elevated gastric lesions: virtual gastroscopy.

With the development of multidetector computed tomography and the improvement in the capabilities of workstations, the use of high-quality three-dimensional reconstructions and virtual images can be applied to organs other than the colon such as the stomach. As a noninvasive technique, virtual gastroscopy represents an alternative to conventional endoscopy for the detection of elevated lesions. Findings of this technique are illustrated.

Adult↗
PubMed2004

Usefulness of three-dimensional, multidetector row CT (virtual gastroscopy and multiplanar reconstruction) in the evaluation of gastric cancer: a comparison with conventional endoscopy, EUS, and histopathology.

BACKGROUND: The aim of this study was to assess the role of three-dimensional multidetector row CT for detection, precise localization, and staging of gastric cancer by comparison with conventional endoscopy, EUS, and histopathology. METHODS: Sixty-three patients with gastric cancer (31 early stage, 32 advanced) were evaluated by EGD with biopsies, EUS, and three-dimensional multidetector row CT between January 2003 to August 2003. Three-dimensional multidetector row CT findings were analyzed by a single radiologist blinded to the endoscopic findings. Among 63 patients, the findings were confirmed in 48 at surgery or by EMR. In the remaining cases, the findings were confirmed by EGD and biopsy specimen. The accuracy of three-dimensional multidetector row CT for detection, localization, and staging of gastric cancer was determined, compared with endoscopy, EUS, and histopathology. RESULTS: Among the 63 patients, there were 67 gastric cancers. The overall accuracy of three-dimensional multidetector row CT for detection of gastric lesions was 94% (63/67), with accuracies of 96.7% (30/31) and 100% (32/32) for detection of, respectively, early and advanced stage gastric cancer. The overall accuracy, sensitivity, and specificity for EUS and three-dimensional multidetector row CT in the pre-operative determination of depth of invasion (T stage) were, respectively, 87.5%, 82.4%, and 96%; and 83.3%, 69.1%, and 94.4%. The accuracy, sensitivity, and specificity of EUS and three-dimensional multidetector row CT for lymph node staging was, respectively, 79.1%, 57%, and 89.5%; and 75%, 57.4%, and 89.3%. CONCLUSIONS: Three-dimensional multidetector row CT, along with virtual gastroscopy is a promising method for pre-operative evaluation of gastric cancer.

Adult↗
PubMed1978

Acupuncture in gastroscopy.

The analgesic effect of acupuncture was evaluated by a double-blind controlled trial in 90 patients undergoing gastroscopy. The endoscopy was much easier and better tolerated after real acupuncture had been performed.

Acupuncture Therapy↗
PubMed1984

[Comparative study of intravenous midazolam and diazepam used as sedative agents during gastroscopy].

Midazolam was compared with diazepam for the intravenous sedation of gastroscopy patients. 0.1 mg X kg-1 midazolam were given to patients less than 65 years old, and 0.085 mg X kg-1 after that age; diazepam doses were 0,2 mg X kg-1 and 0.15 mg X kg-1 respectively. The effect and duration of action of both drugs were similar. The main differences between them were as follows: the intravenous injection of midazolam was not painful, and virtually no venous complications were seen; amnesia and patient contentedness were more frequent with midazolam; gastric secretion was reduced with midazolam. Neither drug had clinically significant cardiovascular effects.

Benzodiazepines↗
PubMed1984

[Intravenous sedation for gastroscopy: comparison between midazolam and diazepam].

Benzodiazepines are often used as premedication or intravenous sedative agents for endoscopies. The present study included 74 patients. It compared the sedative and amnestic properties of midazolam and diazepam, their relative potencies as well as the comfort of both the patient and the endoscopist during gastroscopy. The comparison has shown some statistically significant differences, allowing the following conclusions: amnesia was more frequent with midazolam; the dose requirement (in mg X kg-1) for adequate sedation was more important with diazepam, confirming the greater potency of midazolam; generally speaking, sedation was excellent with both drugs.

Adolescent↗
PubMed1998

An investigation into the information obtained by patients undergoing gastroscopy investigations.

The benefits of informing patients before undergoing surgery or other investigative procedures are clearly demonstrated in the literature. This study aimed to determine the amount and type of information given to patients before, during and after undergoing gastroscopy investigations. A survey approach incorporating structured interviews and structured observation was utilized. There were statistically significant differences between the information acquired by younger and older patients prior to, but not during or after, the procedure. Nurses appear to be the most important source of information for older patients while the information leaflet was perceived as the most important source of information for younger patients.

Adult↗
PubMed2003

Information provided to patients undergoing gastroscopy procedures.

This study aimed to investigate the information provided to patients undergoing gastroscopy procedures in Northern Ireland. Questionnaires were developed by the authors and were completed by 402 patients (RR = 43.8%) and 62 nurses (RR = 75.6%). Patients received most of the procedural information from nurses, and they recognized the importance of providing sensory information. Patients were generally satisfied with the information provided. There is clear evidence of fragmented care, and major changes are required to ensure that patients receive holistic information that includes procedural and sensory aspects. Nurses and doctors must realize that their role in information giving is to ensure that comprehensive information is provided by the appropriate professional at the appropriate time.

Adult↗
PubMed2005

The clinical value of taking routine biopsies from the incisura angularis during gastroscopy.

BACKGROUND AND STUDY AIMS: The incisura angularis is considered to be a typical site for Helicobacter pylori colonization, glandular atrophy, intestinal metaplasia, gastric ulcer, and gastric carcinoma. Our aim was to clarify whether it is necessary to biopsy the incisura angularis routinely during gastroscopy, in addition to obtaining biopsies of the corpus and antrum. PATIENTS AND METHODS: A total of 272 consecutive patients, with a mean age +/- SD of 53.8 +/- 15.5 years, had two biopsies taken from the angulus, two from the antrum, and two from the corpus of the stomach during routine upper gastrointestinal endoscopy. Histological specimens were examined according to the updated Sydney System for the classification and grading of gastritis. RESULTS: Of the 272 patients, 11 (4.0 %) showed chronic inflammation in the angulus biopsy only. Similarly, the angulus was the only biopsy site which showed neutrophil polymorph infiltration (or "activity") in two patients (0.7 %), intestinal metaplasia in 13 patients (4.7 %), atrophy in three patients (1.1 %), and H. pylori colonization in one patient (0.4 %). Dysplasia (intraepithelial neoplasia) was not found in any of the biopsied sites in any of the 272 patients. H. pylori was found in 39 of the 272 patients (14 %). Of the 272 patients, 120 patients showed abnormalities at the incisura angularis, 101 having gastropathy or erosions, and only 19 showing more specific macroscopic changes, the main ones being ulcer, ulcer scarring, and atrophy. Of the 152 patients with a normal-looking mucosa at the angulus, only six (3.9 %) showed the histological changes of chronic inflammation in the angulus alone. Similarly, the angulus was the only biopsy site which showed neutrophil polymorph infiltration in one patient (1/152, 0.7 %), and intestinal metaplasia in five patients (5/152, 3.3 %). Atrophy and H. pylori colonization were not seen exclusively at the angulus in any of the patients with a macroscopically normal-looking angulus. CONCLUSION: Based on our data, routine biopsy of the incisura angularis would provide little additional clinical information to that obtainable from antrum and corpus biopsies.

Adolescent↗
PubMed1984

[Diagnostic value of unselected biopsies during gastroscopy].

In a prospective study 1414 unselected biopsies were obtained during 509 consecutive gastroscopies. Concordance between endoscopic and histological diagnosis was judged by means of the kappa coefficient. Best agreement was obtained with biopsies from the duodenal bulb, at 67.6% (kappa = 0.39). With biopsies from the body of the stomach agreement was only 35.7% (kappa = 0.12), from the antrum 28.8% (kappa = 0.10). Degree of agreement between endoscopic and histological result was independent of the instrument used, but was clearly dependent on the examining doctor and the number of examinations. The results suggest that clinically significant disease is often overlooked during endoscopy alone, unless simultaneously obtained unselected biopsies are examined at the same time. Thus, endoscopic examination alone missed Crohn's disease, chronic atrophic gastritis and various degrees of dysplasias. Unselected biopsy aids in objectifying the gastroscopic findings and in securing the diagnosis of various diffuse gastric mucosal changes.

Biopsy↗
PubMed1983

Comparison of midazolam and diazepam in doses of comparable potency during gastroscopy.

The water soluble benzodiazepine midazolam was compared with diazepam, in doses of 0.07 mg kg-1 and 0.15 mg kg-1 respectively, administered i.v. to 100 patients undergoing gastroscopy. The degree of sedation, ease of endoscopy and recovery were comparable in the two groups. The effects of both drugs on arterial pressure were similar. Compared with diazepam, midazolam had a faster onset of effect, caused virtually no pain on injection, and provided a greater degree of amnesia.

Adult↗